COVID-19 has been overwhelming. Like many people these days, I am up at night, worried about what the pandemic will mean for my loved ones, my community and the world in general. Experiencing change of this scale is new for all of us. The full ramifications of this crisis on the rights of women and gender diverse people remains to be seen. There is one trend – worryingly – that we have seen before in public health crises and are currently seeing again – the neglect, oversight, and in some cases, erosion of rights relating to our sexual and reproductive health (SRHR). At the heart of this is access to abortion.
Sexual and reproductive health services, including safe abortion, are essential, life-saving care. This does not change in times of crisis. If anything, rates of unintended pregnancies spike during public health emergencies or disasters, across restrictive and less restrictive settings.
In Canada, calls to a 24-hour info line offered by Action Canada for Sexual Health and Rights jumped by 30 per cent in the last two weeks of March; while in the Philippines, since the COVID-19 lockdown in Manila the Women’s Global Network for Reproductive Rights (WGNRR) has similarly experienced a spike in email inquiries regarding options for unintended pregnancies. Global evidence shows us time and again that denying access to abortion does not reduce abortions; it only makes them unsafe. Treating the provision and uptake of comprehensive sexual and reproductive health services as anything less than essential, particularly during public health emergencies, will only contribute to increases in maternal morbidity and mortality, disproportionately affecting those who are poor.
In times of relative stability, SRHR are already some of the most challenging rights to fulfill worldwide, particularly for young women, adolescent girls and 2SLGBTQ+ groups. Making inroads on sexual and reproductive rights, particularly expanding access to safe abortion, means grappling with issues that, for some, can be difficult or uncomfortable at best. Issues like acknowledging (young) women’s sexuality, challenging the conflation of womanhood with motherhood, embracing sex positivity, recognizing gender and sexuality as a spectrum of identities and experiences and respecting all people’s bodily autonomy. More often than not, these are highly fraught and contested subjects, and require going up against entrenched social norms and patriarchal structures. There is almost always resistance or pushback from anti-rights or conservative groups. As a result, working to achieve sexual and reproductive rights, especially in terms of protecting and/or expanding access to safe abortion, requires ongoing work, diligence and persistence from women’s rights activists on the ground.
In times of crisis, sexual and reproductive health services may be de-prioritized or wrongly considered non-essential. Even in Canada, where abortion has been decriminalized for more than 30 years, there was initial uncertainty regarding whether provincial governments would treat abortion as essential care during COVID-19 responses. At worst, anti-choice or conservative groups may use public health emergencies as a guise to rollback or attack sexual and reproductive rights. We have already seen this in the United States, where officials in Alabama, Arkansas, Louisiana, Ohio, Oklahoma, Tennessee and Texas attempted to use COVID-19 responses as a pretense to suspend access to abortion services.
Responses to COVID-19 may overtake or derail abortion advocacy efforts, as well. Consider a country like the Philippines, where abortion access is highly contested and women’s rights activists have been calling for decriminalization of abortion. Advocacy efforts may be mistakenly dismissed as untimely or irrelevant. We have already seen this playing out in Argentina, where newly elected president Alberto Fernández had promised to introduce a bill into Congress that would legalize abortion (thanks to historic momentum and feminist mobilization). This legislative process was set to be initiated in March but was postponed due to a nationwide quarantine and suspension of in-person congressional hearings. The end result? Further uncertainty about when such legislation will be introduced or advanced.
This is why, if I’m not careful, thinking about the ripple effects and long-term impacts of public health crises can overwhelm me. And yet, while the full-scale impact of COVID-19 is undoubtedly daunting, something about this particular crisis feels different and, in some respects, provides me with hope.
While affecting all of us, COVID-19 also highlights the cracks of inequality that in other times we might gloss over. It forces us collectively to take a long, hard look in the mirror. There’s opportunity for systemic, structural change, because while we have achieved many hard-won gains to advance gender justice, there is still a long way to go.
And while the full effects of COVID-19 remain to be seen, in some ways we know what to expect, based on lessons learned from past public health emergencies such as the Ebola crisis in Sierra Leone. This means, if we’re paying attention, we can better prepare for, and even maybe alleviate, adverse outcomes. In this sense, public health crises, if approached comprehensively, are an opportunity for us to do better in our efforts to meaningfully realize women’s rights and gender justice.
Integral to the change we need is the ongoing work that women’s rights organizations and activists undertake worldwide: creating the space to advocate for SRHR issues, protecting and expanding access to services. I have been so proud of the global leadership Canada has taken on sexual and reproductive health and rights, specifically our willingness to fund programming on neglected areas such as safe abortion and advocacy, as well as support feminist advocates at the frontlines in Canada and around the globe. As governments ramp up responses to COVID-19, we must be vigilant against attempts to use COVID-19 as a means to rollback SRHR, dismiss advocacy for SRHR, or stop providing essential sexual and reproductive health services. We need integrated COVID-19 responses that address shortages and disruptions in sexual and reproductive health services, global supply chains and commodities, and barriers to accessing care; as well as sustained, comprehensive, and stand-alone SRHR programming.
We need the work that’s already being done on the ground by Oxfam’s partners, like WGNRR. The words of their Executive Director, Marevic Parcon, struck a chord with me when she said “any public health strategy that is not mindful of human rights, including sexual and reproductive health and rights, will be inept and unsustainable and will also create massive grounds for human rights violations.”
Both within COVID-19 responses and beyond, I firmly believe we must continue to support women’s rights organizations, activists and human rights defenders who are holding the line for gender justice and SRHR. They are the ones pushing for the systemic and structural change that we so sorely need and, in doing so, we need to have their backs, now more than ever.
Lara Cousins is Oxfam Canada’s Women's Rights Knowledge Specialist (International Programs).